What are diet therapies for epilepsy?

The classic ketogenic diet has been used as a medical treatment for many years.

When you are on the ketogenic diet you eat a lot of fat, a moderate amount of protein, and almost no carbohydrates.

Everything you eat must be weighed on a special scale. It has to be very exact, and all food must be eaten in its entirety for the diet to be the most effective.

Less restrictive diets are now available:

Instead of weighing food using a gram scale, you will learn to estimate the amounts of carbohydrates, fats and protein based on portion sizes and household measurements.

Modified Atkins Diet for Epilepsy (MADE) - The original Atkins diet was designed for weight loss. MADE has been designed for seizure control with a lower carbohydrate limit and emphasis on high amounts of fat.

Low Glycemic Index Treatment (LGIT) - The LGIT focuses on the type of carbohydrates in the diet limiting to carbohydrates with a glycemic index of 50 or less. This allows for a few more carbohydrate foods.

These diets take a lot of hard work. Your health care team is here to help you, but your family needs to be committed to making the diet work.

Diet therapies for epilepsy are medical therapy and should never be started without a dietitian's guidance and your health care team's approval.

Who should try it?

Ask your team about the ketogenic diet if one or two medications have failed to help you, or if your medicine is hard to take because it makes you feel bad. Anyone who gets all of their nutrition by formula or tube feeding should also consider the diet.

Will it really help?

Lots of research has been done on the ketogenic diet. We have learned:

1/3 of people on the diet experience very good results

1/3 experience some benefit

1/3 of the patients experience no benefit or find the diet too hard to stay on

When will it work?

Some people have an immediate improvement on the diet. Others might need to be on the diet for up to three months before they know if it will help. You will work closely with your health care team during this time to make any necessary adjustments to your diet and medications.

If the diet works for you, we recommend staying on it for up to two years and then slowly starting back on a regular diet.

What foods can I eat?

The diet includes:

A lot of butter, oil and heavy whipping cream

No bread, pasta, rice, cereal or other grains

Moderate amounts of high protein foods like beef and chicken

Small amounts of vegetables and fruits

Caffeine-free, carb-free, calorie-free drinks

Your dietitian will give you lots of choices for meals and snacks. These will tell you exactly how much food you can eat.

Even though you will be eating carefully planned meals, you MUST take vitamin and mineral supplements. Your dietitian will help you find the best ones to take.

What happens next?

First, you need to purchase and read the book and review the Web sites mentioned at the bottom of this page.

Next, set up an appointment with the dietitian:

Pediatric (less than 18 years old): Call 843-792-3307 and ask to be scheduled with the pediatric neurology dietitian. Your appointment will be on the 1st floor in the pediatric neurology clinic in Rutledge Tower

Adult (18 and older): Call 843-792-3223 and ask to be scheduled with the adult neurology dietitian. Your appointment will be on the 2nd floor in the adult neurology clinic in Rutledge Towe.

You will meet with a dietitian to review the diet. You will need to be weighed and measured. You will be provided with a lab order for baseline labs to be done fasting before starting the diet.

You will need to purchase a special scale (only for classes ketogenic diet) to weight your foods, vitamin supplements, and dip sticks to test your urine. Insurance may or may not cover the cost of these itesm.

For the classic ketogenic diet, plan to be available to MUSC for training for a 2-3 hour class to ensure the safety of beginning the diet.

Your dietitian will teach you how to make your special meals using the scale.

Once you complete diet tracking you will have check ups with your dietitian and blood draws every 3-6 months to make sure you are doing well on this very special diet.

What if I don't eat?

People who are tube fed can still enjoy the benefits of the ketogenic diet! Your dietitian will explain how to make a ketogenic formula.

For more information refer to the following books and Web sites:

The Ketogenic Diet: A Treatment for Epilepsy4th EditionBy John M. Freeman, Eric Kossoff